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Objective:To investigate the feasibility of using shear wave dispersion (SWD) imaging in evaluating acute graft-versus-host disease (aGVHD) of the liver.Methods:A total of 42 Wistar rats were used as receptors and 10 Fischer 344 rats were used as donors for bone marrow transplantation to establish aGVHD models. Six rats were randomly selected every week for clinical observation and scoring. Then, ultrasonic SWD was performed to obtain shear wave speed (SWS) and shear wave dispersion slope (SWDS). Then, the histological characteristics were used as a reference standard, and the rats were divided into two groups: the group without aGVHD (nGVHD group) and the group with aGVHD. The differences in the clinical score and SWD values between the two groups were compared, the meaningful indexes were screened by binary Logistic regression analysis, and the joint prediction parameters were obtained. The ROC curve was plotted and the diagnostic efficiency was compared. The correlations between SWS, SWDS, clinical score and pathological grade were analyzed.Results:Clinical score, SWS, and SWDS in aGVHD group were higher than those in the nGVHD group (all P<0.05). The correlation between SWDS and pathological grade ( r=0.774, P<0.001) was higher than those between SWS, clinical score and pathological grade ( r=0.579, P=0.005; r=0.452, P=0.034). Logistic regression showed that SWDS was a significant indicator. In addition, the AUC values determined by SWDS and predictive parameters were (0.859, 0.886), which were significantly higher than the AUC of the clinical score (0.760, P<0.05). Conclusions:SWD imaging technology may become a promising method to evaluate hepatic aGVHD.
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Objective:To analyze the viscosity characteristics of liver tumors and investigate the clinical value of shear wave dispersion (SWD) in the differentiation of benign and malignant liver tumors.Methods:A total of 103 patients with focal liver lesions were prospectively collected in Zhongshan Hospital Affiliated to Fudan University from October 2020 to July 2021, including 80 cases with single lesion and 23 cases with multiple lesions, and only the largest lesion was observed in patients with multiple lesions. SWD values were measured within the tumor and in the liver parenchyma 2 cm away from the tumor, and were compared between benign tumor group and maligant tumor group. The ROC curves of SWD value, SWD ratio and their combination in differentiating benign and malignant liver tumors were plotted respectively, and the optimal diagnostic threshold, the sensitivity, specificity and accuracy of different diagnostic methods were analyzed.Results:Among the 103 patients, 35 were benign and 68 were malignant. The SWD value of liver benign tumor group was lower than that of liver malignant tumor group [(16.38±3.58)m·s -1·kHz -1 vs (18.59±3.12)m·s -1·kHz -1], the SWD value of liver parenchyma background in liver benign tumor group was lower than that in liver malignant tumor group [(10.88±3.37)m·s -1·kHz -1 vs (14.31±3.34)m·s -1·kHz -1], and the differences were statistically significant (all P<0.05). The SWD ratio of benign tumor to surrounding liver parenchyma was higher than that of malignant tumor group [1.57(1.25, 2.00) vs 1.27(1.06, 1.57)], and the difference was statistically significant ( P<0.05). When the SWD value >15.60 m·s -1·kHz -1 was used as the cut-off value, the area under ROC curve (AUC) was 0.72, the sensitivity was 88.2%, the specificity was 51.4%, and the accuracy was 75.7%. The sensitivity, specificity, accuracy and AUC were 58.8%, 74.2%, 63.1%, and 0.68, respectively, when the ratio of SWD value<1.32 was used as the cut-off value. SWD value combined with SWD ratio for the diagnosis of liver malignant tumor, the AUC was 0.88, the sensitivity was 82.3%, the specificity was 83.0%, and accuracy was 81.6%. The diagnostic efficacy of the two in combination for liver malignant tumor was superior to SWD value ( Z=2.678, P=0.007 4) and SWD value ratio ( Z=3.822, P=0.000 1). Conclusions:SWD imaging can reflect the viscosity information of liver tumors and surrounding liver parenchyma, and has potential clinical application value in the differentiation of benign and malignant tumors.
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Objective:To investigate the clinical value of ultrasound shear wave dispersion (SWD) imaging in assessing the hepatic inflammation activity in patients with chronic hepatitis B.Methods:Fifty-two patients with chronic hepatitis B who underwent liver biopsy in Peking University Third Hospital and Beijing Ditan Hospital Affiliated to Capital Medical University from December 2020 to December 2021 were prospectively enrolled.Liver stiffness (LS) and shear wave dispersion slope (SWDS) were measured by SWD imaging in all participants. Baseline data and laboratory indexes of liver function were collected.Liver inflammation grading(G0-G4) and fibrosis staging (S0-S4) were determined by pathological examination. The relationship between SWDS and various indicators was analyzed by univariate and multivariate linear regression analysis. The participants were grouped according to the pathological grading of hepatic inflammatory activity. The differences of various indexes among three groups were compared, and the correlations between SWDS, LS and laboratory indicators and hepatic inflammatory activity were analyzed. The ROC curve was used to evaluate the diagnostic performances of ultrasound and laboratory indicators for hepatic inflammation activity, and the diagnostic accuracy of different indicators was compared by Delong test.Results:Inflammation and fibrosis were both independent affecting factors of SWDS (all P<0.05); there were significant differences in alanine transaminase(ALT), aspartate aminotransferase(AST), LS and SWDS among groups with different inflammatory activities (all P<0.05). The SWDS and LS of the G3 and G2 groups were statistically higher than those of the G1 group (all P<0.001). ALT was only significantly different between G1 group and G2 group ( P<0.05), and AST was only significantly different between G1 group and G3 group ( P<0.05); The SWDS and LS showed strongly positive correlation ( rs=0.728, P<0.001) and moderately positive correlation ( rs=0.679, P<0.001) with hepatic inflammatory activity, respectively; while the correlations between ALT, AST and hepatic inflammatory activity were weaker( rs=0.376, P<0.05; rs=0.485, P<0.001). The area under the ROC curve, sensitivity and specificity of SWDS for diagnosing hepatic inflammation ≥G2 grade were 0.965, 0.933 and 0.865, respectively. Conclusions:SWDS has certain value in evaluating the hepatic inflammatory activity of ≥G2 grade in patients with chronic hepatitis B.
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Objective To investigate the initial clinical value of shear wave elastography ( SWE ) combined with shear wave dispersion ( SWD) in preoperatively differentiating diagnosis of focal liver lesions ( FLLs) . Methods Eighty‐three patients diagnosed as FLLs were prospectively enrolled from January to April 2018 in Zhongshan Hospital of Fudan University . M easurements of SWD and SWE both inner FLLs and surrounding liver parenchyma 2 cm away from the board lines of lesions were performed . ROIs were placed within the lesions and surrounding parenchyma 2 cm away from the lesions . In each ROI , measurements were performed 13 times . Histopathological results after operation were regarded as gold standard ,and the values of viscoelasticity in differentiating diagnosis of FLLs were analyzed . Results The final histopathological results showed that of all 83 cases ,20 cases were diagnosed as benign lesions ( 5 cases of focal nodular hyperplasia ,15 cases of hemangioma) ,and 63 cases as malignant lesions ( 12 cases of liver metastases ,51 cases of hepatocellular carcinoma) . T he SWE of benign lesions and malignant lesions were ( 9 .94 ± 8 .22) kPa ,and ( 13 .68 ± 7 .80) kPa( P ＜0 .05 ) . T he SWD of benign lesions and malignant lesions were ( 13 .47 ± 2 .76 ) ( m/s)/kHz ,and ( 15 .00 ± 3 .82 ) ( m/s)/kHz ( P ＜0 .05 ) . T he SWE ratio and SWD ratio of benign lesions to surrounding liver parenchyma were higher than those of malignant lesions( all P ＜
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Objective To detect the viscoelasticity of carotid artery in healthy volunteers using ultrasonic shear wave dispersion ( SWD ) technique ,and explore the feasibility and influencing factors for SWD parameters . Methods Forty‐five healthy volunteers were recruited and divided into elder group ( ≥50 years old) and younger group ( ＜50 years old) according to the age . T he carotid arteries were examined by SWD at systole ,axial elastic modulus ( SWER ) and viscous index ( SWDR ) were obtained . T he pulse wave velocity ( PWV ) ,a carotid artery circumferential elastic parameter was obtained and considered as the reference indicator . T he difference of SWE R ,SWDR and PWV were compared between two groups ; and the correlation between them were analyzed by Pearson analysis ,respectively . Results ① Compared with the younger group ,the carotid PWV increased ,w hile SWE R and SWDR decreased in the elder group ( all P ＜0 .05) . ②In all subjects ,SWER was negatively correlated with PWV ( r ＝ －0 .256 , P ＜ 0 .05 ) . In the elder group ,SWER was negatively correlated with systolic blood pressure ( r ＝ －0 .357 , P ＜ 0 .05 ) ,and SWDR was negatively correlated with PWV ( r ＝ －0 .393 , P ＜0 .05 ) . In the younger group ,SWDR was positively correlated with systolic blood pressure ( r ＝0 .366 , P ＜0 .05) . Conclusions Compared with the elder group ,the carotid viscoelasticity was higher in young people ,and it is correlated with PWV . SWD can evaluate carotid viscoelasticity ,and contribute to better understanding of its tissue characteristics .
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Objective@#To investigate the initial clinical value of shear wave elastography (SWE) combined with shear wave dispersion (SWD) in preoperatively differentiating diagnosis of focal liver lesions (FLLs).@*Methods@#Eighty-three patients diagnosed as FLLs were prospectively enrolled from January to April 2018 in Zhongshan Hospital of Fudan University. Measurements of SWD and SWE both inner FLLs and surrounding liver parenchyma 2 cm away from the board lines of lesions were performed. ROIs were placed within the lesions and surrounding parenchyma 2 cm away from the lesions. In each ROI, measurements were performed 13 times. Histopathological results after operation were regarded as gold standard, and the values of viscoelasticity in differentiating diagnosis of FLLs were analyzed.@*Results@#The final histopathological results showed that of all 83 cases, 20 cases were diagnosed as benign lesions (5 cases of focal nodular hyperplasia, 15 cases of hemangioma), and 63 cases as malignant lesions (12 cases of liver metastases, 51 cases of hepatocellular carcinoma). The SWE of benign lesions and malignant lesions were (9.94±8.22)kPa, and (13.68±7.80)kPa(P<0.05). The SWD of benign lesions and malignant lesions were (13.47±2.76)(m/s)/kHz, and (15.00±3.82)(m/s)/kHz(P<0.05). The SWE ratio and SWD ratio of benign lesions to surrounding liver parenchyma were higher than those of malignant lesions(all P<0.05). The SWE ratio of benign and malignant lesions were 2.60±2.65, and 1.40±1.40, respectively (P<0.05). The SWD ratio of benign and malignant lesions were 0.92±0.44, and 0.80±0.51, respectively(P<0.05).@*Conclusions@#With the advantages of effectiveness, convenience, non-invasiveness and repeatability, combined measurement of SWE and SWD has a potential value in differentiating diagnosis of liver lesions.
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Objective@#To detect the viscoelasticity of carotid artery in healthy volunteers using ultrasonic shear wave dispersion (SWD) technique, and explore the feasibility and influencing factors for SWD parameters.@*Methods@#Forty-five healthy volunteers were recruited and divided into elder group (≥50 years old) and younger group (<50 years old) according to the age. The carotid arteries were examined by SWD at systole, axial elastic modulus (SWER) and viscous index (SWDR) were obtained. The pulse wave velocity (PWV), a carotid artery circumferential elastic parameter was obtained and considered as the reference indicator. The difference of SWER, SWDR and PWV were compared between two groups; and the correlation between them were analyzed by Pearson analysis, respectively.@*Results@#①Compared with the younger group, the carotid PWV increased, while SWER and SWDR decreased in the elder group(all P<0.05). ②In all subjects, SWER was negatively correlated with PWV (r=-0.256, P<0.05). In the elder group, SWER was negatively correlated with systolic blood pressure (r=-0.357, P<0.05), and SWDR was negatively correlated with PWV (r=-0.393, P<0.05). In the younger group, SWDR was positively correlated with systolic blood pressure (r=0.366, P<0.05).@*Conclusions@#Compared with the elder group, the carotid viscoelasticity was higher in young people, and it is correlated with PWV. SWD can evaluate carotid viscoelasticity, and contribute to better understanding of its tissue characteristics.
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Objective • To examine the carotid viscoelasticity by using ultrasonic shear wave dispersion (USWD) technique, and to preliminarily analyze its correlation with blood flow shear rate. Methods • Forty-five patients of General Surgery Department of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from December 2018 to January 2019 were recruited, and divided into the elder group (≥ 50 years old) and the younger group (<50 years old) according to the median age. The carotid viscoelasticity of the patients was examined by USWD technique and the indexes were obtained, including carotid shear wave elasticity (SWER), shear wave dispersion (SWDR), blood flow maximum shear rate (SRmax) and mean shear rate (SRmean). The correlations between SWER, SWDR and blood flow shear rate were analyzed by Pearson correlation, respectively. Results • ① Compared with the younger group, the carotid artery SWER, SWDR, SRmax and SRmean of the patients in the elder group were lower (all P<0.05). ② The SWER and SWDR of carotid artery of all patients were positively correlated with SRmax and SRmean, respectively (all P<0.05). Conclusion • Carotid arterial viscoelastic index based on USWD technique is closely related to the blood flow shear rate, which is expected to provide a new perspective for the study of carotid arterial diseases.
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Objective: To observe the feasibility of ultrasound shear wave dispersion imaging (USWD) in evaluating carotid viscoelasticity. Methods: Totally 45 volunteers were recruited and divided into 2 groups according to age, i.e. ≥50 years old group (n=23) and <50 years old group (n=22). Four shear wave viscoelastic modulus of the common carotid artery (CCA), including shear wave elastic modulus values of the superficial and deep walls (SWES and SWED), shear wave dispersion values of superficial and deep walls (SWDS and SWDD) were obtained using USWD, respectively. In addition, the pulse wave velocity (PWV) was measured. The viscoelastic indexes were compared between the two groups, and the correlations with age, blood pressure and PWV were analyzed. Results: Before and after adjusted with body mass index, systolic blood pressure (SBP) and diastolic blood pressure (DBP), SWES, SWED, SWDS and SWDD were higher in <50 years old group than those in ≥50 years old group (all P<0.05). Among all subjects, SWE was negatively correlated with age, SBP, DBP and PWV, respectively (r=-0.282, -0.374, -0.321, -0.256, all P<0.05). SWD was negatively correlated with PWV in ≥50 years old group (r=-0.393, P=0.038), while positively correlated with SBP in <50 years old group (r=0.366, P=0.048). Conclusion: The viscoelasticity of arterial wall can be non-invasively and quantitatively assessed with USWD.
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Objective: To measure the carotid viscoelasticity using ultrasound shear wave dispersion (USWD), and to explore the correlation between the viscoelasticity and hemodynamics. Methods: Forty-fve volunteers without history of cardiovascular and cerebrovascular events were recruited and divided into elder group (≥50 years old, n=23) and younger group (<50 years old, n = 22) according to the median age. The common carotid arteries were detected by USWD, and SWER (elastic index) and SWDR (viscous index) were obtained. Hemodynamic parameters, including velocity time integral (VTI), peak systolic velocity (PSV), end-diastolic velocity (EDV), and mean flow velocity (MFV), were measured using Doppler ultrasound. Correlations between SWER, SWDR and hemodynamic parameters were analyzed using Pearson analysis. Results: The SWER, SWDR, VTI, PSV, EDV and MFV in the elder group were significantly lower than those in the younger group (P<0.05, P<0.01). The SWER was positively correlated with VTI, PSV, EDV and MFV (r=0.354, 0.400, 0.467 and 0.310; P<0.01, P<0.05). The SWDR was negatively correlated with VTI and PSV (r= - 0.481 and - 0.522, both P<0.01), but positively correlated with MFV (r=0.352, P<0.01). Conclusion: USWD may identify the change of carotid viscoelasticity, and the change of viscoelasticity is related to hemodynamics.
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Objective To establish an ultrasonic viscoelastic detection system to measure the viscoelasticity of in vitro tissues. Methods Based on the method of shear wave dispersion ultrasound vibration (SDUV), this system applied acoustic radiation force to excite harmonic vibration in soft tissues. The propagation of shear waves induced by the vibration was detected and the tissue viscoelasticity properties were calculated. The standard phantom and rat liver experiment were conducted using this system, and preliminary assessment of the system was completed. Results The measured result of standard phantom was close to the calibration value. The viscous and elastic coefficient of rat liver were (1.12±0.41) Pa•s and (0.81±0.40) kPa, respectively. Conclusions The results about the standard phantom and rat liver experiment approved feasibility of the system for viscoelasticity measurement on in vitro animal experiment, which is a preliminary exploration for the realization of liver fibrosis detection of human body.